Abstract
No sponsorships or competing interests have been disclosed for this article.Received April 5, 2017; accepted April 11, 2017.The month of July has finally arrived, and I hope that many of you are finding time to enjoy travel, family, friends, and relaxation. Again, summer takes me “down the shore,” where I can enjoy long, warm days to both unwind and to catch up with some of the latest information in our specialty. I hope that you are able to do the same. In that spirit, I have highlighted 5 articles for you to begin your journey through this month’s issue.
In our first article, Soulier and colleagues 1 assess quality of life among 807 patients with vestibular schwannoma (VS) treated with various treatment modalities. In this article, the authors used the Penn Acoustic Neuroma Quality of Life (PANQOL) scale to evaluate patients treated for VS over a 10-year period in the Netherlands. After using propensity scoring and with stratification by tumor size, total and domain-specific scores were calculated for all subjects. The primary finding of the study is that patients with small VS (<10 mm) reported higher better quality of life with observation than with any type of active treatment. In addition, there was a strong negative correlation between the presence of symptoms such as imbalance/vertigo and quality of life. Soulier and colleagues discuss the implications of their findings for clinical practice and patient education.
In our second article, Roden and associates 2 compare survival outcomes between unimodality and multimodality treatments for early stage tonsillar squamous cell carcinoma (SCC). The authors used the National Cancer Database (NCDB) to assess patients with clinical stage I to II SCC of the tonsil between 1998 and 2011. They identified 3247 patients in their sample and noted that 39.9% were treated with radiotherapy (RT) alone, 35.4% with surgery alone, and the remainder (34.7%) with combined surgery and RT. Among this group, the authors noted that multimodality treatment had the highest 5-year survival at 81.1%. They further noted that addition of tonsillectomy to RT offered an incremental survival of about 20% over RT alone. While noting the limitations of their retrospective database research, the authors discuss that additional research is indicated to optimize treatment for these patients with early stage tonsillar SCC.
In the third article, Moshtaghi and colleagues 3 report on the efficacy of otolaryngology-performed in-office ultrasound (US) in the clinical assessment of lateral neck masses. The authors performed a retrospective assessment of 59 patients with lateral neck masses who underwent otolaryngology-performed US and US-guided fine-needle aspiration in 1 academic center from 2012 to 2015. They noted that in-office US revealed additional findings not identified on physical examination, such as nonpalpable lymph nodes, in 37% of patients, which either assisted in surgical planning or altered the course of treatment. Moshtaghi and associates argue that in-office US augments the care given by otolaryngologists and should be considered as the primary imaging and diagnostic modality for the workup of lateral neck masses.
Finally, in this issue, we present 2 articles that focus on the treatment of sinonasal rhabdomyosarcoma (SNRMS). Given the rarity of these neoplasms, these 2 articles are notable in their presentation of clinical and prognostic information. In the first of these 2 articles, Unsal and colleagues 4 report on 286 patients with SNRMS gathered from the Surveillance, Epidemiology, and End Results database over a 40-year period from 1973 to 2013. The authors reported on all-age patients with a median age at diagnosis of 24.5 years. They noted overall 5-, 10-, and 20-year disease-specific survival was 35.1%, 25.4%, and 12.0%, respectively. In addition, they noted that distant metastasis decreased 5-year survival from 35.1% to 3.8%. In the second article, Stepan and colleagues 5 report on 186 adult patients gathered from the National Cancer Database over the period of 2004 to 2013. In contrast to Unsal et al, 4 the authors looked only at patients 18 years or older and excluded children younger than 18 years. Stepan and colleagues 5 noted a similar 5-year survival of 28.4% in their sample, with improved 5-year survival among patients older than 35 years. They also noted that distant metastasis was associated with a lower 5-year survival, at 14.7% in their patient cohort. These 2 articles both demonstrate that SNRMS has a poor prognosis and that patients presenting with distant metastatic disease have worsened 5-year survival.
In addition, we again feature our special section on patient safety/quality improvement (PS/QI) this month. We have a number of articles that look at varied issues such as thermal variation among operative microscopes 6 and patient safety event reporting. 7 Please pay special attention to these valuable PS/QI papers as you read July’s issue.
Once again, please enjoy the papers found in the July issue of Otolaryngology–Head and Neck Surgery.
Footnotes
No sponsorships or competing interests have been disclosed for this article.